Key result
Vigorous intensity exercise was associated with a lower prevalence of moderate-to-severe aortic stenosis (OR 0.43; 95% CI 0.20-0.94) in patients with a bicuspid aortic valve.
Why the study?
The potential impact of exercise on valvular function and aortic diameters in patients with a bicuspid aortic valve remains unclear.
Does lifelong exercise volume, intensity, or sport type affect valvular function and aortic diameters in patients with a bicuspid aortic valve?
Cross-Sectional (n=407)
Does lifelong exercise volume, intensity, or sport type affect valvular function and aortic diameters in patients with a bicuspid aortic valve?
Odds Ratio: 0.43 (95% CI 0.2–0.94)
Lifelong exercise, including vigorous intensity and mixed sports, does not appear to induce adverse cardiovascular effects in patients with a bicuspid aortic valve and may be associated with a lower prevalence of aortic stenosis.
Supports exercise safety counseling in bicuspid aortic valve; leaves open whether vigorous activity protects against stenosis in prospective studies.
Background The potential impact of exercise on valvular function and aortic diameters in patients with a bicuspid aortic valve remains unclear. Therefore, we assessed the association between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve. Methods and Results In this cross‐sectional study, exercise volume (metabolic equivalent of task minutes per week), exercise intensity, and sport type were determined from the age of 12 years to participation using a validated questionnaire. Echocardiography was used to assess aortic stenosis or aortic regurgitation and to measure diameters at the sinuses of Valsalva and ascending aorta. Aortic dilatation was defined as a Z ‐score ≥2. Four hundred and seven patients (42±17 years, 60% men) were included, of which 133 were sedentary (<500 metabolic equivalent of task minutes per week), 94 active (500–1000 metabolic equivalent of task minutes per week), and 180 highly active (≥1000 metabolic equivalent of task minutes per week). Moderate‐to‐severe aortic stenosis or aortic regurgitation was present in 23.7% and 20.0%, respectively. Sinuses of Valsalva and ascending aorta diameters were 34.8±6.6 and 36.5±8.1 mm, whereas aortic dilatation was found in 21.6% and 53.4%, respectively. Exercise volume was not associated with valve dysfunction or aortic dilatation. Vigorous intensity and mixed sports were associated with a lower prevalence of aortic stenosis (adjusted odds ratios, 0.43 [0.20–0.94] and adjusted odds ratios, 0.47 [0.23–0.95]). Exercise intensity and sport type were not associated with aortic regurgitation and aortic dilatation. Conclusions We found no deleterious associations between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve. Vigorous intensity and exercise in mixed sports were associated with a lower prevalence of moderate‐to‐severe aortic stenosis. These observations suggest that lifelong exercise does not appear to induce adverse cardiovascular effects in patients with a bicuspid aortic valve.
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Schreurs et al. (2024) conducted a cross-sectional in Bicuspid aortic valve (n=407). Lifelong exercise (vigorous intensity) vs. Lower intensity exercise or sedentary lifestyle was evaluated on Moderate-to-severe aortic stenosis (OR 0.43, 95% CI 0.20-0.94). Vigorous intensity exercise was associated with a lower prevalence of moderate-to-severe aortic stenosis (OR 0.43; 95% CI 0.20-0.94) in patients with a bicuspid aortic valve.
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